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NPI Code Detail

MEDICARE: SKYLAR NICHOL BAIR PA-C

MEDICARE:   SKYLAR NICHOL BAIR  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant2024039143MO

General Provider Information

NPI Number : 1942029038
Entity Type Code : Individual
Provider Name (Legal Business Name) : SKYLAR NICHOL BAIR PA-C
Provider Business Mailing Address
First Line : 16759 MAIN ST STE 201
Second Line :
City : WILDWOOD
State : MO
Zip : 63040-1232
Country : US
Telephone Number : 618-381-2341
Fax Number :
Provider Business Practice Location Address
First Line : 16759 MAIN ST STE 201
Second Line :
City : WILDWOOD
State : MO
Zip : 63040-1232
Country : US
Telephone Number : 636-821-1662
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2024
Last Update Date : 10/07/2024

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Directions to “ SKYLAR NICHOL BAIR PA-C” Practice Location

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